29 August 2012 12:36 PM

Patients missing appointments - maybe they never needed them?

If someone doesn’t turn up for an appointment there are only
a few possible reasons: they died; they forgot; transport failure or they didn’t
need the appointment in the first place. The figures for the number of people
not turning up for NHS appointments were revealed over the bank holiday weekend
– one
in ten people don’t attend an appointment totaling 5.5m missed
appointments in the last year. This includes appointments people have made for
themselves.

BBC local radio also covered yesterday the forthcoming
2020health report on how few people are being given electronic access to their
health records (one in 100), despite the evidence showing that patients who
take up the service usually have better health.

The common theme here is that NHS remains far too
paternalistic, with doctors making many decisions without involving the
patient and still regarding intimate details about an individual’s life history
(i.e. the patient’s notes) as belonging to the state. Legally notes do still
belong to the NHS, but despite the fact we have had the right to see our
records for a couple of decades, many professionals still view us as
passive recipients of care instead of active participants who should be involved
in planning and management. This includes whether we really want an appointment, or just a quick call for reassurance or leaving it to us to decide. I recently sat by a doctor’s desk in a large
London teaching hospital as he viewed his PC. He hadn’t looked up when I walked
into the room; he’d spoken to either the notes or the screen, and it was only
when I said “and I’d like a copy of my test results” that he looked at me. “Why
would you want those?” he asked abruptly as if talking to an unreasonable
child.

Personal electronic health records will go a long way to
enabling us to take more responsibility for our healthcare. More information
leads to greater understanding and awareness and can lead to improved health. The
proliferation of health apps show that there is a real appetite for information
and self-care. The government should be falling over itself to encourage
electronic access and approving apps as this will reduce the burden on the NHS
and go some way to reducing the 40% (according to GPs) of unnecessary
appointments, easing the difficulties experienced by some patients who have
found it harder to get an appointment because of their
local surgery reducing their opening hours. And if we really are going to
have a system that people value and includes rights, responsibilities and
redress, then we should be charged the cost of the appointment if we don’t show
up (easily done with an electronic system) which will help us decide whether we needed the appointment in the first place!

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JULIA MANNING

Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer in at City University, visiting clinician at the Royal Free Hospital, working with Primary Care Trusts and a Director of the UK Institute of Optometry. She also specialised in diabetes and founded Julia Manning Eyecare, a practice for people with mental and physical disabilities. In 2006 she established 2020health.org, an independent Think Tank for Health and Technology. Research publications have covered public health, telehealth, workability, pricing of medicines, biotechology, NHS reform and fraud.